Saturday, February 2, 2019

Equipping Pastors and Leaders Series: Caring for Those Grieving the Loss of Someone to Suicide


The following is my teaching outline for a workshop I taught for pastors and leaders (November 2018) in Long Beach, CA.  
Resources to support those who are grieving the loss of someone to suicide

aka: survivors of suicide (the family and friends left behind after their loved one dies by suicide)


This org is based in Garden Grove, CA.  They have a support group 2x month in Garden Grove.  Their website also has an extensive list of current area support groups, in Los Angeles and Orange County.


The website of the American Foundation for the Prevention of Suicide has a thorough list of book recommendations.




How grieving a suicide death is different from many other deaths: SHAME and TRAUMA


Handout #2: Do’s and Don’t When Supporting a Survivor of Suicide


Do’s and Don’ts When Supporting a Survivor of Suicide



Things to say/do…

·         How are you feeling today?

·         I don’t know what to say…

·         This must be so hard for you…

·         I can’t imagine what you are going through, but I wanted to let you know that I’m here if you’d like to talk. I’m not sure what to say, but I’m here to listen

·         Recall a positive memory about the person who died

·         I miss (name of the person who died)… how are you?

·         Can I take you anywhere that would help? (doctors, shopping, appointments etc)

·         Would you like to go for a walk together?

·         What can I do to help?  (And offer a few specific things)

·         What do you need?  Do you want to talk about your feelings? To not talk about your feelings?  To do something quiet together?  To go to a movie and laugh?  To be present while you do paperwork?

Spend some time processing what this suicide brings up for you and how that might impact your ability to care.



What not to say/do…

·         Avoid asking for details about the death itself, such as how the person died, who saw it, etc.

·         Avoid asking questions that try to piece together why it happened.

·         Avoid clichés such as “They are in a better place” “Time heals everything” “they are at peace now”

·         Avoid phrases such as “It was God’s will” “It was his time to go Home.”

·         Avoid initiating questions of personal faith or theology, “did s/he know Jesus?” “well, I believe suicide is not a sin…”

·         Avoid trying to find silver linings, “isn’t it good that the kids weren’t home…”

·         Avoid identifying with the loss, “I know how you feel…” (unless you did lose someone to suicide)

·         Avoid talking a lot about your own experiences, especially if they are not suicide bereavement

·         Phrases that could be seen as judgmental, such as “they were selfish to do that” “they took an easy way out”

·         Don’t share the news unless at the request or with permission of the survivor (don’t post on social media, don’t put on the prayer chain)

Don’t avoid the survivor. 

Equipping Pastors and Leaders Series: Caring for Someone who is Suicidal


1.       Introduction


From 1999-2016, death by suicide rose on average 25%.  In CA, 14.8%.  In ND it rose the most, 57%.  Only NV state saw a decrease of 1%.  (Source: CDC’s National Vital Statistics System, Vital Signs, 2018)

Suicide is the 10th leading cause of death for all ages, in the US.  It is the 2nd leading cause of death in the world for those aged 15-24 years. (for more statistics, see https://save.org/about-suicide/suicide-facts/

2.       Recognizing warning signs and risk factors






A note about cutting and other forms of self-injury:  They are considered a risk factor for suicide, even though the intent is not death.

“Cutting (on the wrist usually), burning or otherwise harming one’s self without the intention of suicide is referred to as “parasuicidal behavior” by mental health professionals. People who engage in this behavior often report that in some way it makes their experiences seem more real again (when things feel numb), that it brings with it a feeling of control (when other things seem out of control), or that it is even a form of self-punishment. Cutting IS dangerous because although persons who cut will usually report they have no intention of suicide, it is a form of suicide rehearsal. Also – there is serious risk of making a “mistake” and actually killing one’s self, not to mention the risk of infection, the feelings of shame that get associated with the cutting (which is usually experienced as an uncontrollable compulsion to cut), etc.” (Mark Dombeck, Ph.D, https://www.mentalhelp.net/advice/cutting/)

3.       Resources for when someone is suicidal

Don’t be afraid to ask direct questions!  Here are some helpful questions to ask:

1.       Are you thinking of killing yourself?

2.       Have you attempted suicide in the past?

3.       Do you have a plan?

4.       Do you have the means available to you?

5.       When would you do this?

6.       Can we make a plan so you will be safe? (to not be alone, to check in regularly, to start/go to therapy, go to psychiatrist, do self-care activities, etc.)

Passive suicidal ideation – when a person “wants to die” or “wishes s/he wasn’t alive” but has no risk factors for action.  Don’t assume such statements are PSI.  Ask!  Such statements can often be an Indicator of depression; it is important to pursue treatment but it’s not an emergency.

If you face a suicide emergency, call 911 or go to your local hospital emergency room. If needed, they may keep the person for a 72 hour hold.  If the person doesn’t go voluntarily, an evaluation team may enact a 5150, or involuntary 72 hour hold.  The 72 hours can be extended if needed.

Long Beach has two “urgent care” centers for mental health issues. 

Behavioral Health Urgent Care Center (sponsored by LA County) in Long Beach (opened 2018)




Mental Health Urgent Care Center in Long Beach


Orange County Mental Health Emergency Resources


In the bigger picture of your sphere of influence:

1.       Don’t be afraid to talk about suicide, especially when it is prominent in the media.

2.       Teach people to process loss, to share vulnerabilities in safe relationships and to create life-giving meaning in suffering.

Dr Jerry Reed of the National Action Alliance for Suicide Prevention told the BBC, "We can't take for granted that everyone learns this by some magic formula… We learn how to read, how to write. We also have to help people learn how to cope.” (https://www.bbc.com/news/world-us-canada-44416727)

Christmas 2018: What's in a Name?


In 2018 we celebrated our 10th anniversary as an organization.  As a way of honoring this milestone, I want to share a bit about the history and meaning of our name.    

Going back a few years… in 2006 a friend approached Don Diva and me about creating healing opportunities for a group of young adults.  We were inspired to create a conference context where young adults could experience

relational and spiritual healing in a context of worship and experiential learning.  We gathered a team and named the conference, the “Soul Restoration Project.”  In 2007, when we realized it made sense to form an organization that would bring together the various facets of the healing work we were doing, the name stuck.  “Soul Restoration Project” embodies our values – spiritual integration, depth-process restoration and a commitment to creativity and healthy boundaries.   

SOUL… it connotes complexity, depth and aliveness.  Soulful music, for example.  But what is the soul?  Definitions vary, depending on who you ask.  Biblically, a Hebrew word often translated as “soul” is “nephesh.”  It appears in the creation story (Gen 2:7) where it is often translated as “living being.”  “Then the Lord God formed man from the dust of the ground, and breathed into his nostrils the breath of life; and the man became a living being (nephesh).”  In Greek, the word “psyche” is often translated “soul.”  For example, Jesus says, (Mt 5:8), “What good is it for man to gain the whole world but lose his soul (psyche)?”  We think of the soul as the core self, a self embodied and created for life, complexity and depth.  This is true for each person we work with.      

RESTORATION… consider the things we restore: vintage cars, art work, architecture, ecosystems.  “Restoration” connotes a process involved in repairing things of great value.  That’s very different than fixing broken stuff.  This is the work we do: through a process that is attuned to the unique needs of our clients, we seek to bring to health aspects of the self (or relationships) that have been damaged or never developed. 

PROJECT...  Project connotes two ideas to us: creativity and boundaries.  When we did our first conference, our plates were full of full-time jobs in other ministries, grad school and a myriad of other commitments.  Calling it a “project” helped us to conceptualize our commitment as limited to one conference.  It gave us freedom to work on this “project,” without taking on more than we could handle.  Of course, we have taken on quite a bit over the years.  But we also maintain an attentiveness to healthy boundaries, knowing that boundaries enable us (and our clients) to truly thrive and be present.  “Project” also, very importantly, connotes creativity.  We are working on a project that requires our best selves and our greatest creativity.  It is a project worthy of focus and prayer.  Whether in how we lead a workshop or conference, to how we organize SRP, to how we sit with our clients, we seek to creatively bring new life.    
Much has changed since our first conference in 2006.  We are now a group of ten wonderful, talented therapists who embody our SRP values and who are committed to learning and growing together.  And we continue to expand our network to better support churches, ministries and others in the communities of north Orange County and Long Beach.  We give thanks for you and your part in this Soul Restoration Project!

Christmas 2017: #metoo and a Return to Fidelity


As 2017 comes to a close we are grateful for the opening of our second office in Long Beach.  And in 2018 we will celebrate Soul Restoration Project’s 10th anniversary!  We celebrate the growth that has come from deep and steady work.  We thank you – friends, colleagues, pastors and clients -- for your contribution to our work.

One of our greatest goals at SRP is to help individuals, couples and families have faithful and intimate relationships.  Much of this work has to do with working though wounds and blocks that impact their capacity to slow down, trust and in all ways develop healthy relationship. 

A significant focus of SRP is working with those struggling with sexual addiction, their partners and other victims of traumatic sexual experiences.  Don Diva, Arsen Muradyan and Andy Park are trained Sexual Addiction Therapists who help sex addicts and their partners recover healthy sexuality and emotional functioning. 

I (Catherine Morrill) and Andy Park treat trauma sufferers with various modalities, including EMDR (eye movement desensitization and reprocessing).  EMDR (www.emdria.com) helps individuals revisit and transform traumatic experiences so as to foster healing and resilience.  Several of our interns will be trained in EMDR in 2018.  We seek to keep abreast of the advances in the fields of trauma and sexual addiction. 

This fall the issues we deal with regularly at SRP were in the news and culture in an unprecedented way.  The #metoo movement gave women the courage to voice their stories of sexual harassment or trauma.  As women voiced their experiences, the #metoo movement led to the firing of a number of big names.  I keep wondering what stories will surface next.  I hope this conversation will reorient people to long for honorable and faithful relationships rather than instant gratification.  And I hope and pray victims will experience healing. 

One word has been capturing my attention: FIDELITY.  What a beautiful word!  Fidelity is defined primarily as valuing and being faithful, often regarding one’s spouse but also extending to an idea or organization.  The word comes from the Latin root, fides.  Words with this root have something to do with being faithful.  It is the same root found in the words confident (faith in self) and the verb to confide (faith in the other). 

Fidelity has its own reward: it creates the trust and stability necessary for closeness.  And fidelity has its own difficulties.  Remaining faithful necessitates facing the challenges of relationship difficulties, disappointments and loneliness.  It entails feeling feelings and doing difficult relationship work that we would probably prefer to avoid and that we may not know how to do.  Remaining faithful also doesn’t mean a relationship will (or should) last.  Nonetheless learning to remain faithful to others is good for the soul.  It fosters wholeness.     

This year, as I consider the Christmas story, I think of Joseph, whom some have called the hidden man of Christmas.  I think of Joseph’s fidelity to Mary and how he chose to trust Mary and God when he could have recoiled at the strange and difficult path ahead.  He chose Mary and God above self-promotion or entitlement.  How different our history is because of the fidelity of Joseph. 

At SRP we seek to help our clients find the healing that enables fidelity and that produces wholeness. 

We – the SRP staff – are thankful for you who have joined with us on this journey. 

Christmas 2016: Politics and Loving the Other

Christmas came so quickly this year!  I think we were all hoping for a little peace and quiet after the Presidential election.  But peaceful and quiet it is not! 

I see a lot of parallels between our division as a nation and the divisions that bring couples to counseling.  Politically-- accusations, wounds, misinformation and fear abound.  Arrogance and prejudices are exposed.  Likewise when a couple comes for counseling, they often bring a story of a descent into hostility, polarization, fear, hurt and distrust.  They are committed but don’t know how to heal. 

It is difficult to love (or like) “the other”… whether “the other” is different in political views, gender, parenting style, cultural background or temperament.  It is difficult to overcome deep wounds and longstanding patterns. 

Our goal at the Soul Restoration Project is to help couples (as well as individuals and families) grow in awareness, honesty, vulnerability, faithfulness and responsiveness to “the other(s)” that they love.  Charisma and arrogance only hinder this work of personal growth.  Rather it is in quiet connections, in tears, in thoughtfulness and in new commitments, that we develop emotionally...  And become more vulnerable and resilient.  More loving.  The healing of our communities depends on it. 

When I think of the Christmas story this year, I think about how Jesus didn’t come in the power of charismatic persuasion, money or military might.  Instead Jesus came as a little baby in the context of the faithful humility and vulnerability of ordinary humans, Mary and Joseph… ordinary people participating in this most extraordinary story.  The contrast-- between the many very ordinary elements of the story and the amazing, supernatural Restoration that was emerging in this quiet ordinariness at the same time-- is beautiful and powerful.

The classic Christmas hymn, O Holy Night, speaks beautifully of Jesus’ ordinariness and vulnerability, that “He knows our need, to our weakness is no stranger…”  This humble beginning of God being with us makes even more beautiful the amazing supernatural story unfolding.  The lyrics continue,

Truly He taught us to love one another;
His law is love and His gospel is peace.
Chains shall He break for the slave is our brother;
And in His name all oppression shall cease.
Sweet hymns of joy in grateful chorus raise we,
Let all within us praise His holy name.

When we participate in the beauty of the humble and quiet but very powerful and freeing work of God – as therapist, client or partners-- it leads to freedom and gratitude.  This Restoration is holy ground.  We are thankful for all who participate with us in this endeavor.    

Sunday, August 21, 2016

What is Dynamic Psychotherapy?

Dynamic Psychotherapy: A Depth-Oriented Approach

There are many approaches to counseling and psychotherapy.  Each approach, and each therapist, answers the question, “How does healing happen?” somewhat differently.  If I were to articulate my approach succinctly, I believe that healing happens in the context of being deeply known and understood such that we can understand ourselves (and others) and thereby grow as more whole people and gain the wisdom and courage to choose well for ourselves and for our relationships. 
 
Dynamic psychotherapy is an orientation to therapy that facilitates this process.   It is appreciated by clients because the experience of depth listening can uniquely address the deep and various parts of the self and relationships.  This approach helps clients experience and resolve core developmental needs that so often contribute to unresolved relational, sexual or psychological issues.  It can be used to address a variety of presenting problems, whether anxiety, depression, couples communication breakdowns, eating disorders, sexual addiction.  Dynamic psychotherapy as a general orientation may incorporate interventions from other traditions such as cognitive behavioral exercises, EMDR, body work, expressive therapy exercises, etc.  It can be utilized in individual as well as couples work. 

The following is a summary introduction to dynamic psychotherapy by Dr. Lawrence Hedges (used with permission). 

“Dynamic psychotherapy originated with the work of Dr. Sigmund Freud in Vienna in the late nineteenth century. Therapy is both a way of understanding human emotions and of helping people with their relationships and their personal problems. The mature or rational self that functions more or less successfully in the real world is only a part of the total person. The more immature, irrational, or unconscious self functions silently in the background to produce various symptoms and maladaptive behaviors that often intrude into the person's social life, personal relationships, school or work activities, and physical health. In dynamic psychotherapy specific problems are viewed in the context of the whole person. The quest for self-knowledge is seen as the most important key to changing attitudes and behavior.

Dynamic psychotherapy is based on the insight that our personalities are the result of passing through and solving relationship issues at many developmental stages. At any stage, the way we have reacted to events in our lives may have caused us to get stuck at a certain level of insight or problem solving. While we go ahead and mature satisfactorily, in many ways we may carry within us the parts that didn't have a chance to develop. We can have a mature exterior and be functioning more or less successfully, while internally we may feel vulnerable, confused, depressed, angry, afraid, and childlike. We may not feel able to bounce back from rejection, get past blocks, allow our real feelings to surface, or stay in touch with our feelings and desires. Our physical health may be compromised in many ways by emotional and relationship issues.

Dynamic psychotherapy is designed to help the client get in touch with her or his unconscious memories, feelings, and desires that are not readily available to the conscious mind. Therapy is designed to help clients of all ages understand how their unconscious feelings and thoughts affect the ways they act, react, think, feel, and relate. Whether or not therapy works depends a great deal on the client's willingness and ability to experience all relationships deeply, especially the therapeutic relationship. Each client, by expressing her or his story in whatever ways possible to someone who knows how to listen and to give new meanings back, has the opportunity to learn about herself or himself in a new way.

Dynamic psychotherapy can provide a safe place for people of whatever age to discover for themselves their own truths. It provides a unique opportunity to re-experience personal history in a new relationship, to see it in a new way, and to make connections between past and current conflicts that illuminate the way one relates to oneself and to others.

Clients are encouraged to talk about thoughts and feelings that come up about therapy or about the therapist. These feelings are important because elements of one's earliest affections and hostilities toward parents and siblings are often shifted onto the therapist and the process of therapy. This phenomenon, known as "transference," offers a rich source of understanding, for it offers the possibility for people to re-experience and re-work important feelings arising from the past with the maturity they possess in the present.

Dynamic psychotherapy is usually not a short-term therapy as it takes time to explore the complex layers of feeling and experience that make up a person's own unique relationship history. People find that their therapy can easily extend for several years but there is no prescribed length of treatment. Only the people closely involved have a sense of when personal goals have been met. When the client feels she or he has accomplished the desired goals, then a termination date can be set and agreed upon.

Dynamic psychotherapy aims to help people experience life more deeply, enjoy more satisfying relationships, resolve painful conflicts, and better integrate all the parts of their personalities. Perhaps its greatest potential gift is the essential freedom to change and to continue to grow in relationships.”
 
In the context of a consultation, I would be happy to assess what approach might be most beneficial to address your concerns.  Please contact me by phone (714-262-4445, ext. 2) or email (Catherine@soulrestorationproject.org) to set up an appointment. 
 

Wednesday, April 20, 2016

Taking a Time-Out, for Couples

How can you and your significant other manage a conversation that is escalating into a fight?  You know how you feel when the cycle is in motion...  You get triggered... and then you find yourself unable to refrain from yelling, or bringing up the past, or blaming or shutting down.  We sometimes hope that this time the conversation will end differently.  But usually it doesn't.  Often hurtful words are exchanged, deepening the disconnection.

When couples get stuck in destructive patterns of fighting, calling a time-out can help interrupt it.

A time-out is a structured format that interrupts a negative cycle by allowing time for the body and the brain to recover from the physiological arousal of fight/flight/freeze that can get activated in the face of conflict.  With a time-out a person can more likely transition to using the part of the brain (the pre-frontal cortex) that is capable of thoughtfulness, awareness and care.

There are important elements that help a "time out" be successful, rather than an exercise in frustration or failure.  For example, essential to "calling a time-out" is an honest commitment to resume the conversation at a specific time.  This helps the partner who would rather continue the conversation/fight feel some reassurance that the time-out isn't "just an avoidance tactic."

A time-out can give a couple a needed break to come back to each other in a more constructive way.  But calling a time-out isn't easy... it requires agreement, discipline and practice.  If you are needing a tool to help decrease destructive conflicts and increase connection, give it a try! 

When I work with couples we read through the following structured way of calling a time-out, consider how it might be helpful, how it might be difficult, and then, if they think it will be beneficial, they agree to practice the following the steps.

Successfully implementing this has helped many couples feel more confident, loving and secure.  Let me know how it goes!  -- Catherine Morrill       

So, here it is...
How to Take a Time-Out
 
 A time-out can help you avoid saying or doing things that will hurt your relationship.  A time-out is NOT meant to help you avoid issues.  It is a tool that can help you regain perspective so that you CAN more successfully work through and resolve an issue.

Start by becoming familiar with the indicators that you need a time-out.  They may include:
·        You are so overwhelmed by your feelings of anger, frustration, jealousy or other strong emotion that you can’t relate meaningfully.

·        You want to escalate the conflict to prove your point or “make” the other person hear you.

·        You want to bring up things from the past that you know would be hurtful.

·        You have lost perspective and are no longer thinking about resolution or understanding.

·        You are unable to articulate your thoughts and feelings in a meaningful way.  Perhaps you are blaming the other person or are shut down.

·        You are not able to listen to your partner.  You may be interrupting, making assumptions and/or dismissing what s/he is saying.

·        You are feeling unsafe.
Then Take a Time-Out Using These Steps:
1.      Call a Time-Out

a.      State that you need a time-out.  Ie: “I need a time-out.”  NOT “You” or “We” …need a time out.

b.      Affirm that you are willing to continue the conversation.

c.      Suggest and agree on a time to continue the conversation.
 
2.      Do some individual work: relax, reflect, remember

·        Do something to release the emotional intensity: deep breathing, go for a walk/run, go outside, pray/meditate, take a shower.

·        Ask yourself what triggered your emotional response.  Journal your thoughts and feelings to help you understand what is happening inside of you.  Utilize the “What are we Fighting About” sheet to consider the layers.

·        Remember what’s important: creating a win-win and understanding one another is more important than “winning” the fight.

3.      Resume the conversation

·        Listen generously, seeking to understand his/her thoughts and feelings.

·        Share your own thoughts, feelings and needs.

·        Consider what you could repair by apologizing [see apology blog].

A time-out is simple (in some ways) but by no means easy.  And it isn't one size fits all.  For help in your relationship, I welcome you to contact me to set up a consultation.  You can email me at Catherine@soulrestorationproject.org or call me at 714.262.4445, ext. 2.